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\/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-biorxiv-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n \n \n \n \u003Cdiv class=\u0022pane-content\u0022\u003E\n \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 data-highwire-cite-ref-tooltip-instance=\u0022highwire_reflinks_tooltip\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article abstract-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003EAbstract\u003C\/h2\u003E\u003Cp id=\u0022p-2\u0022\u003EThe co-circulation of different arboviruses in the same time and space poses a significant threat to public health given their rapid geographic dispersion and serious health, social, and economic impact. Therefore, it is crucial to have high quality of case registration to estimate the real impact of each arboviruses in the population. In this work, a Vector Autoregressive (VAR) model was developed to investigate the interrelationships between discarded and confirmed cases of dengue, chikungunya, and Zika in Brazil. We used data from the Brazilian National Notifiable Diseases Information System (SINAN) from 2010 to 2017. There were two waves in the series of dengue notification in this period, one occurring in 2013 and the second in 2015. The series of reported cases of both Zika and chikungunya reached their peak in late 2015 and early 2016. The VAR model shows that the Zika series have a significant impact on the dengue series and vice versa, suggesting that several discarded and confirmed cases of dengue could actually have been cases of Zika. The model also suggests that the series of confirmed chikungunya cases is almost independent of the cases of dengue and Zika. In conclusion, co-circulation of arboviruses with similar symptoms could lead to misdiagnosed diseases in the surveillance system. We argue that the use of mathematical and statistical models routinely in association with traditional symptom-surveillance could help to decrease such errors and to provide early indication of possible future outbreaks. These findings address the challenges regarding notification biases and shed new light on how to handle reported cases based only in clinical-epidemiological criteria when multiples arboviruses co-circulate in the same population.\u003C\/p\u003E\u003C\/div\u003E\u003Ch3\u003ECompeting Interest Statement\u003C\/h3\u003E\u003Cp id=\u0022p-3\u0022\u003EThe authors have declared no competing interest.\u003C\/p\u003E\u003Ch3\u003EFunding Statement\u003C\/h3\u003E\u003Cp id=\u0022p-4\u0022\u003EThis work is supported by the Center of Data and Knowledge Integration for Health (CIDACS) through the Zika Platform- a long-term surveillance platform for the Zika virus and microcephaly, Unified Health System (SUS) - Brazilian Ministry of Health.\u003C\/p\u003E\u003Ch3\u003EAuthor Declarations\u003C\/h3\u003E\u003Cp id=\u0022p-5\u0022\u003EAll relevant ethical guidelines have been followed and any necessary IRB and\/or ethics committee approvals have been obtained.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EYes\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EAll necessary patient\/participant consent has been obtained and the appropriate institutional forms have been archived.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ENot Applicable\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EAny clinical trials involved have been registered with an ICMJE-approved registry such as ClinicalTrials.gov and the trial ID is included in the manuscript.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003ENot Applicable\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EI have followed all appropriate research reporting guidelines and uploaded the relevant Equator, ICMJE or other checklist(s) as supplementary files, if applicable.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003ENot Applicable\u003C\/p\u003E\u003Cdiv class=\u0022section data-availability\u0022 id=\u0022sec-1\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EData Availability\u003C\/h2\u003E\u003Cp id=\u0022p-13\u0022\u003EAll data will e available in the manuscript after acceptance in journal.\u003C\/p\u003E\u003C\/div\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003C\/div\u003E \u003C\/div\u003E\n\n \n \u003C\/div\u003E\n\u003Cdiv class=\u0022panel-separator\u0022\u003E\u003C\/div\u003E\u003Cdiv class=\u0022panel-pane pane-biorxiv-copyright\u0022 \u003E\n \n \n \n \u003Cdiv class=\u0022pane-content\u0022\u003E\n \u003Cdiv class=\u0022field field-name-field-highwire-copyright field-type-text field-label-inline clearfix\u0022\u003E\u003Cdiv class=\u0022field-label\u0022\u003ECopyright\u0026nbsp;\u003C\/div\u003E\u003Cdiv class=\u0022field-items\u0022\u003E\u003Cdiv class=\u0022field-item even\u0022\u003EThe copyright holder for this preprint is the author\/funder, who has granted medRxiv a license to display the preprint in perpetuity.\u003Cspan class=\u0022license-type\u0022\u003E It is made available under a \u003Ca href=\u0022http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/\u0022 class=\u0022\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003ECC-BY-NC-ND 4.0 International license\u003C\/a\u003E.\u003C\/span\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E \u003C\/div\u003E\n\n \n \u003C\/div\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022https:\/\/www.medrxiv.org\/sites\/default\/files\/js\/js_SXHPyYQMndPSjH0oAPTy1xd0XLtmYCIziRIiNb0RJd8.js\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}